Play this game, save lives

UAlberta physicians create 'Doctors Against Tragedies,' a game to learn about fentanyl and the opioid crisis.

Laura Vega - 30 January 2018

As opioid overdoses continue to rise, efforts are amping up to educate Canadian populations on the topic of fentanyl. Doctors at the University of Alberta's Faculty of Medicine & Dentistry created a game to help build awareness and prevent fentanyl-related deaths.

"Doctors Against Tragedies"-inspired by the popular game "Cards Against Humanity"-sets an edgy tone to discuss the realities of opioids. The game was designed by Michiko Maruyama, from the departments of Art and Design and Cardiac Surgery at the U of A. Maruyama, a third-year cardiac surgery resident, developed the awareness campaign along with Cheryl Mack from the Department of Pediatrics, and Ferrante Gragasin and Vivian Ip from the Department of Anesthesiology and Pain Medicine.

The team scheduled workshops in January during International Week to play the game on campus with anyone from the public who wanted to join.

"As a cardiac surgery resident I am a part of the transplant team, we deal with heart and lung transplant," said Maruyama. "We have been noticing over the past couple of years that there's been an increase on young donors because of the fentanyl overdose."

"It's quite emotional-we're very thankful that the family of the teenager or young adult has donated their organs, but at the same time it's very hard for us to harvest the organs of someone who was otherwise healthy, and made one unfortunate decision that led to their death."

The four doctors came together to discuss what they could do to help address the fentanyl crisis. They decided that a "fear-tactics" campaign wouldn't be the best approach for their project. Maruyama, who is also a U of A graduate in industrial design, used her educational background and experience to find an easy, approachable and attractive way for teenagers and young adults to talk about fentanyl.

Realizing that the card game "Cards Against Humanity" was very popular among young people, Maruyama contacted the creators of the game and obtained their permission to create a spin-off version centered around opioids.

The team created a sharp, no-filter version for people over 18 years old that resembles the tone of the original game, and a trivia-based version with more appropriate language for teenagers over 12 years old, which can be used in high schools. Maruyama wrote the content of the cards in the adult version, and the team had physicians from across Canada and the U.S. review the accuracy and clarity of the information in both games. More than 200 doctors participated in the review.

In addition to the distinctive dark humour of the game, the cards include useful information like general facts about opioids and contact details for helplines and services related to overdose or drug prevention.

"Fentanyl is a drug that we use at the hospital. It has many uses from general anesthesia to chronic pain," explained Maruyama. "We started to see the negative effects of fear-tactic campaigns, people are coming into the hospital and they don't want to use fentanyl even if it's prescribed. That's something we have to deal with as health-care providers. We wanted to create a campaign that shows both sides and be creative while doing it."

The game is a not-for-profit project. It is available online and both the youth and adult versions can be downloaded for free at The project was made possible through the support of a grant from the Alberta Medical Association, in conjunction with the Canadian Medical Association.

Future plans include distributing the game at public places throughout Edmonton such as coffee shops and pubs, and incorporating an awareness campaign for elementary school kids through a spin-off version of the game Minecraft, with 3D paper characters designed after the four doctors of the team. Maruyama hopes the use of the game spreads all across Canada and beyond to help people learn about opioids.

Michiko Maruyama: Teaching health care through play

Maruyama's talent for art, painting and drawing led her to become an industrial designer. A rare disease and her experience as a patient led her to become a physician. Combining her cardiac surgery residency program with a master's program in industrial design, Maruyama's goal is to integrate art, design and medicine.

Maruyama balances her life as a cardiac surgery resident, an artist, a designer and a new mom. One of her favourite creations is the painting 'Susie the Surgeon'-based on the iconic Rosie the Riveter-which she created to help inspire and empower women to enter the fields of medicine and surgery.

"Doctors Against Tragedies" is an addition to Maruyama's history of creative projects for medical education. Her website Art of Learning includes drawings and articles, 3D anatomically-correct models of organs to cut and fold like origami (which she calls "organami") and other fun projects for children, medical students and even patients to learn about health.

"We have clinician-scientists. My dream would be to develop the role of clinician-designer, or clinician-artist. While some researchers have labs, I would like to have a studio where I can develop medical educational resources," said Maruyama.